Provider Demographics
NPI:1831256890
Name:JAMES A. TUEL PC
Entity type:Organization
Organization Name:JAMES A. TUEL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:TUEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-254-2546
Mailing Address - Street 1:24510 W LOCKPORT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2312
Mailing Address - Country:US
Mailing Address - Phone:815-254-2546
Mailing Address - Fax:815-254-2566
Practice Address - Street 1:24510 W LOCKPORT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2312
Practice Address - Country:US
Practice Address - Phone:815-254-2546
Practice Address - Fax:815-254-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-008289152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208511OtherP TAN
IL9932276OtherBCBS OF IL
ILU41352Medicare UPIN
IL208511OtherP TAN